Ep 67 Hemorrhoids

Contributors: Aisha Powell and Dr. Emran from Simple Health Radio

On today’s episode, Dr. Emran will be discussing “George,” a patient who came into the emergency department with symptoms of hemorrhoids.

George, a healthy 21-year old male, was experiencing pain and bleeding when he went to use the bathroom. He told Dr. Emran that he noticed pressure in the rectal area that would become painful when he moved his bowels and that large amounts of blood would accompany the pain.

After searching for answers on the web and trying over-the-counter medicine, he decided to go to ER because the symptoms were now interfering with his life. The blood would stain his undergarments and his uniform while he was at work.

He had no risk factors, Dr. Emran found. He did not have a history of diabetes or hypertension and did not do anything intentionally to produce the pain. Although George was embarrassed about the pain initially, Dr. Emran reassured him that this was not the first case he’d seen with these symptoms.

Dr. Emran examined George’s rectal area and diagnosed him with hemorrhoids which is a common condition caused by swollen veins in the anus and lower rectum. According to the National Institute of Digestive and Kidney disease, hemorrhoids affect more than 10 million people a year, although only one-third will seek medical treatment.

The condition varies widely with some cases being small and manageable with home remedies, while other cases require professional attention. Due to the nature of hemorrhoids, many people affected by it are embarrassed and hide it from family members and co-workers. However, because the rectal area is more susceptible to being dirty, complications like bacterial infections can be harder to treat.

Hemorrhoids can be caused by a multitude of things. The main instigator is increased pressure to the veins that surround the rectal area, which can happen when someone is pregnant, constipated, doing heavy lifting or certain types of work. You can actually feel the enlarged vein, as it bulges out of the anal canal.

Due to the number of nerves that are in the anus, hemorrhoids can be extremely painful. The bleeding associated with the condition comes from blood-filled veins. When the body tries to decompress, it causes the veins to bulge and bleed. However, the cycle is not over once the veins ooze because they fill right back up with blood. Some people may even develop blood clots, called a thrombosis, which is so painful it usually makes the person go to the ER.

When patients come into the ER with hemorrhoids, Dr. Emran first tries to reduce the inflammation with pain medication like steroid creams and foams. He also uses a “Sitz bath,” a combination of hot water mixed with Epsom salt, making patients sit in the salt water solution to shrink the tissue and reduce the pain. Sitz bath kits are also available in most pharmacies.

If hemorrhoids are caused by constipation, a condition that makes it extremely hard to move bowels because of hardening in your stool, Dr. Emran advises people to get a stool softener, prune juice or something that will keep their bowel movements regular.

If at-home treatments don’t work, Dr. Emran recommends a consultation to see a colorectal surgeon who is a specialist on hemorrhoids.

It is very important that if someone undergoes any surgery that the anal area is kept as clean as possible and lifting is avoided. Healing time can last from several weeks to a month.

Summary:

Hemorrhoids are a common condition caused by extreme pressure in the anal area

Millions of people have suffered from hemorrhoids with mild to severe symptoms

It is important to identify what caused hemorrhoid and proceed accordingly

If you are constipated get a stool softener

If you are lifting heavy, stop lifting until you seek treatment

You can treat hemorrhoids at home with steroid creams and Epsom salt baths

Try to keep the anal area as clean as possible to avoid bacterial infections and if you are bleeding a lot, go see a doctor

If the case has progressively worsened, go see a colorectal specialist

If you think you may have a medical emergency, call 911 immediately. Dr. Emran and Simple Health Radio do not recommend or endorse any specific tests, physicians, products, procedures, opinions, consults, or any other information that may be mentioned on this website or radio podcast.